Gout - Highlights

Highlights

Disease Overview

Gout is one of the most painful forms of arthritis. It may be classified as primary or secondary (caused by other conditions).

There are four stages of the disease. With treatment, most people can avoid progression to the later stages.

• Asymptomatic hyperuricemia ? increased levels of uric acid in the blood, but no symptoms. This stage may last 30 years, and does not always lead to gout. People with asymptomatic hyperuricemia do not usually require treatment.
• Acute gout, or acute gouty arthritis ? uric acid crystals in the joints cause intense attacks of pain, swelling, and other symptoms. Attacks may last for hours to days, or even several weeks, although most subside within 5 to 7 days. Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are the most common treatments for acute gout.
• Intercritical gout ? the periods between attacks. People do not have symptoms during intercritical periods. NSAIDs and colchicine are commonly used to prevent future attacks.
• Chronic tophaceous gout ? if gout continues untreated, the intercritical periods become shorter, and pain becomes chronic. Knobby crystal deposits may form in the joints, outer ear, and other locations. Drugs such as allopurinol (which reduces the body?s production of uric acid) and uricosurics (which increase excretion of uric acid) are used to reduce blood levels of uric acid during this stage.

Recent Research

Vitamin C.Researchers have found that taking 500 mg/day vitamin C significantly reduces uric acid levels. Researchers are investigating whether vitamin C can prevent or treat gout.

Association with coronary artery disease.A mechanism involving the breakdown of cholesterol may contribute to both gout and a higher than normal risk of atherosclerosis and coronary artery disease. Allopurinol has the positive side effect of reducing ?bad? cholesterol, and therefore may be better than other drugs for patients with both gout and coronary artery disease.